United States anesthesiologists over 50: retirement decision making and workforce implications.

Background: Anesthesiology is among the medical specialties expected to have physician shortage. With little known about older anesthesiologists' work effort and retirement decision making, the American Society of Anesthesiologists participated in a 2006 national survey of physicians aged 50-79 yr.

Methods: Samples of anesthesiologists and other specialists completed a survey of work activities, professional satisfaction, self-defined health and financial status, retirement plans and perspectives, and demographics.

Utilizing conjoint analysis to explicate health care decision making by emergency department nurses: a feasibility study.

This descriptive study tests the feasibility of using clinical simulation to understand proxy decision making by emergency department nurses for individuals with intellectual disability (ID). Results from a conjoint analysis used to identify decision-making patterns indicated that nurses relied on future health status, functional status, and family input while making important health care decisions for their clients. This information enhances our understanding of the complex array of services and supports that nurses are expected to provide.

Proxy healthcare decision-making for persons with intellectual disability: perspectives of residential-agency directors.

Directors of residential agencies for persons with intellectual disability in one U.S. state completed a self-administered, mailed survey to assess relative importance of information sources and decision factors in proxy healthcare decision-making.

A content analysis from a US statewide survey of memorable healthcare decisions for individuals with intellectual disability.

Background: Little is known about surrogate healthcare decision-making for individuals with intellectual disability (ID). This study examined healthcare decision-making by residential-agency directors to learn their process and the extent to which the individual is included.

Method: Content analysis of qualitative data from a mailed survey of residential-agency directors in a large US northeastern state.

Prolonged retrograde amnesia following sedation with propofol in a 12-year-old boy.

Propofol is commonly used for sedation in a variety of clinical settings, as well as for induction and maintenance of anesthesia. The ease with which propofol can be administered and titrated to clinical effect, in addition to its accepted safety profile, has made it the drug of choice for sedation in outpatient procedures, such as gastrointestinal endoscopy. While short-term amnesia is a well-known side-effect of propofol, we present the first documented case of prolonged retrograde amnesia following propofol administration in a pediatric patient.

The anesthesia preoperative assessment: an opportunity for smoking cessation intervention.

Smoking is the single most cause of preventable disease and premature death in the United States. We discuss potential hazards that the anesthesiologist should be aware of when caring for patients who abuse tobacco. A review of recent preoperative smoking cessation initiatives is also provided in addition to recommendations on how anesthesiologists may use the preoperative visit as an opportunity to play a more active role in reducing the burden of tobacco-related disease.

Acquiring medical services for individuals with mental retardation in community-based housing facilities.

As a result of deinstitutionalization, individuals with mental retardation (MR) were moved into the community and primary care practices. Residential agency directors now routinely determine health care decisions. Understanding of issues involved in acquiring services and the clinical decision-making experiences of 13 service agency directors representing 1,400 individuals with MR were investigated.

The Health Policy and Legislative Awareness Initiative at the Pennsylvania State University College of Medicine: theory meets practice.

In a constantly evolving health care landscape shaped by many voices--including those of third party payers and government--physicians must learn to play a more proactive role to become better advocates for their patients and to uphold the basic tenets of their noble profession. As legislation and public health become increasingly intertwined with the practice of medicine, educators must provide future physicians with the tools to meet these new challenges. Accordingly, in 1996 Pennsylvania State University College of Medicine embarked on its Health Policy and Legislative Awareness Initiative, a medical school elective designed to provide theoretical knowledge as well as practical experience in legislative and policy issues for future physicians early in their careers.